Surgical instrument



Sept. 1, 1942. E. M. SMITH SURGICAL INSTRUMENT Filed July 15, 1940 EdwinM. l

Afromegg Patente d Sept. 1, 1942 UNITED STATES PATENT OFFICE SURGICALINSTRUMENT Edwin M. Smith, Grand Rapids, Mich.

Application July 15, 1940, Serial N0. 345,455

7 Claims.

This invention relates to a surgical instrument which is particularlydesigned to facilitate and expedite the operation of circumcision.

In carrying out the various objects and purposes of the invention thedevice must consist of two separate parts, one of which is ascissorslike instrument resembling a hemostat and which has its upperouter free ends curved toward each other like beaks and which overlapwhen in closed position. A wire is secured between the ends of thesebeaks and assumes a substantially circular contour between the endsthereof. The second part of the device consists of a spindle which istubular in formation and which I prefer to provide with one end portionsomewhat larger than the other. While it is not necessary that this bedone, it obviates the necessity of having two separate spindles ofdifferent sizes. Near each end of the spindle an annular groove isprovided and in the actual operation the glans is inserted within thetubular end of the spindle and the prepuce is stretched over the outerside of the spindle. The first instrument with the wire attached to theend thereof is then placed around the prepuce in line with the annulargroove and clamped tightly therein. This is then left for a period offrom to minutes after which the prepuce immediately above the wire istrimmed off with a scalpel. By this method and by the use of theseinstruments, bleeding very rarely occurs and no suturing is required.

To the accomplishment of the foregoing and related ends said invention,then, consists of the means hereinafter fully described and particularlypointed out in the claims. The annexed drawing and following descriptionset forth in detail certain means for carrying out my invention, saidmeans constituting, however, but one of various ways in which theprinciple of the invention may be employed.

In said annexed drawing, wherein like reference numerals refer to likeparts throughout the various views:

Fig. 1 is, an elevation of the scissors-like instrument in a partlyclosed position.

Fig. 2 is similar to Fig. l but shows the'instrument in completelyclosed position.

Fig. 3 is a longitudinal section through the spindle showing the glansand prepuce in position thereon during the operation.

Fig. 4 is a fragmentary horizontal section immediately above the wire inFig. 3.

Fig. 5 is a plan view of the instrument shown in Fig. 1, and

Fig. 6 is an enlarged fragmentary perspective view of the beaks of theinstrument in Fig. 1 omitting the wire therefrom.

Referring now more particularly to the drawing and more especially toFigs. 1 and 2, the instrument which resembles a hemostat is provided atits upper end with a pair of curved beaks l and 2 which extend towardeach other,

the beak 2 adapted to lie beneath the beak I when they are in closedposition. These beaks are pivoted together as at 3 and continuedownwardly to form the handle portions 4 and 5- terminating in theopenings 6 for the insertion of fingers to operate the instrument.

The handle 4 has an integral portion extending toward the handle 5 asindicated at I and is provided along its length with a plurality ofteeth 8. The handle 5 also has a shorter portion 9 extending toward theportion 1 and has one or two teeth It) on its under side so that whenthe handles 4 and 5 are pressed together the teeth 8 and II] willcooperate to hold the instrument in closed position at any one of anumber of predetermined points, determined by the number of teeth 8.

The two beaks l and 2 are each constructed slightly different from theother. The beak l terminates at its outer end with a slightly indentedcentral portion II and has adjacent this end the opening [2 whichextends from the upper to the lower side of the beak. The beak 2terminates in the bifurcated portions I3 and where these portions orforks join the main body of the beak a more narrow solid part l4 extendsforwardly between the forks for only a short distance and terminates ina concave end as at I5. In the body of the beak 2 adjacent the pointwhere the two forks begin there is provided an opening l6 similar to theopening l2 in the beak I and which also extends from the upper to thelower side thereof.

A wire I! at one end is inserted through the top of the hole l2, extendsdownwardly therethrough and is curved along the under side thereof for ashort distance as at I8. The other end of the wire I! is located betweenthe forks l3, bears against the concave portion l5 of the member l4,extends downwardly through the opening I6 and is then curved rearwardlyslightly as at Hi. This manner of securing the wire tends to hold it inposition and prevents sliding when the instrument is in a completelyclosed position. Also, as is clearly shown in Fig. 2, when theinstrument is completely closed the portion of the wire I! adjacent andimmediately below the beak I will be received between the forks l3 ofthe beak 2 thus eliminating any interference by either end of the wirewhen the instrument is closed.

While I have mentioned previously that the second part of the device,which I have called the spindle, is provided with a large and small end,it is to be understood that a single tubular member could be usedsatisfactorily without departing in any way from the spirit of theinvention, the particular embodiment being shown and described herebeing merely by way of illustration. Having this in mind, then, andreferring more particularly to Fig. 3, the spindle is provided with asmaller end 20, a large end: 2| and a very small intermediateconnecting,

section 22. I prefer to make the intermediate section small to not onlyadd to the appearance of the instrument but also to lessen its weight.Each end of the spindle is identical with the exception of size and adescription of one end will serve as a description of both.

Through the length of the spindle I provide the opening 23 which, ateach end, flares outwardly so that the cross-section of the interior ofeach end is substantially in the form of a triangle having connectionwith the opening 23 through the length of the spindle. Adjacent each endI provide the annular groove 24 the purpose of which has been alreadymentioned.

In actual use and in performing the operation the glans 25 is placedwithin one endiof the spindle and the prepuce 26 is then extended aroundthe outer side of the end. The first instrument is then opened widelyand inserted around the prepuce in the line of the annular groove 24 andclamped in position. This will give a. crushing effect on the prepuceand after it has been left there for a period of 5 or minutes theprepuce immediately above the wire H is trimmed off with a scalpel andthe Wire removed.

It-will be clear that when it becomes necessary to use the smaller endof the spindle the wire- I] may be replaced by one somewhat shorter butthe replacement will be relatively simple because of the novel manner inwhich the wire is secured to the ends of the. beaks. The spindle hasbeen made hollow for several definite reasons, one being that itprevents a vacuum in attaching theinstrument to the glans and, itpermits the escape of urine in the event that a baby voids during theoperation. It has been determined that the smaller end is suitable forboys from birth to 6 or 7? years of age and the larger size for oldermales.

The instrument has been highly successful and has been used in a greatnumber of operations and found to operate entirely satisfactorily. Itdifferentiates from other instruments used for the same purpose in thatit facilitates the operation, it saves suture material and the completedoperation is much smoother.

Other modes of applying the principle of my invention may be usedinstead of the one here shown, change being made as regards thestructure herein disclosed provided; however, that the means stated byany of the following claims or the equivalent of such stated means beemployed.

I, therefore, particularly point out and distinctly claim as myinvention:

1. An instrument for performing circumcision comprising, two memberscurved toward each other and pivotally secured together, a wire securedto the outer free ends of said members and extending inwardly therefromsubstantially in the form of a ring within the confines of said members,means to hold the prepuce separate from the glans, and means to holdsaid members in closed position with said wire encircling said prepuceto thereby give the wire a crushing action on the prepuce.

2. Aninstrument for performing circumcision comprising, two memberscurved toward each other and pivotally secured together, a wire securedto the outer free ends of said members and extending inwardly therefromsubstantially in the form of a ring within the confines of said members,a tubular member adapted to receive the glans of a person therein withthe prepuce extending over the outer side thereof, said wire adapted to'be placed around said prepuce, and means'to hold the ends of saidmembers tightly closed to give the wire a crushing action on theprepuce.

3. The combination of elements defined in claim 2, wherein said tubularmember has an annular groove adjacent the end thereof into which thewire crushes the prepuce.

4. An instrument for performing circumcision comprising, two beakscurved toward each other and pivotally secured together, one ofsaidbeaks being bifurcated and movable to a positionbeneaththe otherbeak, 'a wire extending between and surrounded by saidbeaks, means tohold the prepuce separate from the glans, and means to hold said beaksin closed position with said wire encircling said prepuce to-therebyimpart a crushing action on the prepuce by said wire.

5. The combination of elements defined in claim 4, said first namedmeans including a small tubular member having an enlarged end thereonwithin which the glans is received, and outside of which the prepuce isplaced.

6; An instrument for performing circumcision comprising, two beakscurved toward each other and pivotally secured together, one of saidbeaks being bifurcated, an opening adjacent the bifurcation through saidone beak, an opening adjacent the end' of the other beak, a wireextending between said beaks having the ends thereof securedin saidopenings, means to hold the prepuce separate from the glans, and meansto hold said beaks tightly closed with said wire encircling said prepuceto thereby impart a crushing action on the prepuce by said wire.

7. The combination of elements defined in claim 6, wherein said firstnamed means includes a small tubular member having an enlarged endthereon to receive the glans on the inside thereof and the prepuce onthe outside thereof.

EDWIN M. SMITH.

